Policy Outlook Summary: Rural Healthcare Transformation Program

On May 5, GNDC hosted a Policy Outlook on the Rural Health Transformation Program to examine a major federal investment aimed at strengthening North Dakota’s healthcare system and supporting rural populations.
 
The conversation was led by Andrea Pfennig, GNDC Vice President of Government Affairs, featuring insights from Emily O’Brien, Deputy Commissioner, North Dakota Department of Health and Human Services.
 
BOTTOM LINE: North Dakota has a significant opportunity—approximately $500 million over five years—to transform rural healthcare delivery, strengthen workforce pipelines, and improve long-term health outcomes. Success will depend on execution, collaboration, and measurable results.
 

 
BREAK IT DOWN:
>> A Major Investment in Rural Health
North Dakota is expected to receive approximately $100 million per year through the Rural Health Transformation Program, totaling $500 million over five years. The program is designed to improve rural healthcare access, quality, workforce capacity, and long-term sustainability.
The state is focused on maximizing impact and ensuring funds are deployed efficiently across communities.
 
>> Workforce: A Critical Pressure Point
Strengthening and stabilizing the rural healthcare workforce is a top priority. Investments include training pipelines, residency programs, and recruitment and retention strategies for critical access hospitals and providers.
North Dakota is facing a workforce crisis making retention, training, and support for existing providers essential to long-term system stability.
 
>> Bringing Healthcare Closer to Home
The program emphasizes expanding access through telehealth, mobile care delivery, and modernization of rural healthcare facilities. Efforts also include improving care coordination and transportation to ensure patients can access services when and where they need them.
The goal is to move rural healthcare systems from survivability to sustainability—and ultimately, long-term viability.
 
>> Cost Drivers and Workforce Health
Chronic disease remains one of the largest drivers of employer healthcare costs and workforce productivity challenges. The program targets key conditions that directly impact absenteeism, retention, and long-term cost trends.
By investing in prevention, wellness, and early intervention, the state is aiming to reduce long-term healthcare costs, improve workforce participation, and strengthen overall economic productivity.
 
>> System Efficiency, Data, and Technology
The program includes investments in data infrastructure, technology, and care coordination to improve system efficiency and reduce fragmentation. Priorities include better data sharing, streamlined health records, and tools that support more effective care delivery.
For employers, this translates to a more efficient healthcare system, improved access to care, and better alignment between providers—helping manage costs and improve outcomes across the workforce.
 
>> Business and Community Engagement
A consistent theme was the importance of collaboration. Healthcare providers, communities, and private sector partners all have a role to play in shaping solutions and delivering outcomes.
The program encourages innovation and partnerships, with flexibility for locally driven ideas that meet community-specific needs.
 
Attendees also gained insight into the pace and rigor of the application process:
“We’re moving quickly to deploy these funds, but we’re also being intentional—ensuring the right metrics, outcomes, and reporting are in place so we can deliver results and meet federal requirements.”
 
We appreciate Deputy Commissioner Emily O’Brien for taking the time to engage with GNDC members—providing clarity on this complex program and outlining opportunities for businesses and communities to get involved.